Aims: To investigate the mental workload level of nurses aiding the most affected area during the Coronavirus disease 2019 (COVID‐19) pandemic and explore the subtypes of nurses regarding their mental workload.Design: Cross‐sectional study.Methods: A sample of 446 frontline nurses participated from March 8 to 19, 2020. A latent profile analysis was performed to identify clusters based on the six subscales of the Chinese version of the National Aeronautics and Space Administration Task Load Index. The differences among the classes and the variables including sociodemographic characteristics, psychological capital and coping style were explored.Results: The level of mental workload indicates that the nurses had high self‐evaluations of their performance while under extremely intensive task loads. The following three latent subtypes were identified: ‘low workload & low self‐evaluation’ (8.6%); ‘medium workload & medium self‐evaluation’ (35.3%) and ‘high workload & high self‐evaluation’ (56.1%) (Classes 1, 2, and 3, respectively). Nurses with shared accommodations, fewer years of practice, junior professional titles, lower incomes, nonmanagement working positions, lower psychological capital levels and negative coping styles had a higher likelihood of belonging to Class 1. In contrast, senior nurses with higher psychological capital and positive coping styles were more likely to belong to Classes 2 and 3.Conclusion: The characteristics of the ‘low workload & low self‐evaluation’ subtype suggest that attention should be paid to the work pressure and psychological well‐being of junior nurses. Further research on regular training program of public health emergency especially for novices is needed. Personnel management during public health events should be focused on the allocation between novice and senior frontline nurses.Impact: This study addresses the level of mental workload of frontline nurses who aid in the most severe area of the COVID‐19 pandemic in China and delineates the characteristics of the subtypes of these nurses.

Background: Overload and anxiety were common phenomena among frontline nurses during the pandemic. Understanding the potential pathway for fostering engagement in high-stress working conditions can provide evidence of targeted intervention to facilitate nurses’ well-being and safety practices. This study aims to investigate the level of nurses’ work engagement during nucleic acid collection tasks in the COVID-19 pandemic and identify its potential antecedents. Methods: A cross-sectional design was adopted. A sample of 824 nurses who engaged in nucleic acid collection tasks completed an online self-report questionnaire between 1 March and 31 May 2022. Descriptive and path analyses were utilized to analyse the interrelationships among anxiety, perceived workload, affective commitment, perceived organizational support and work engagement. This study was conducted and reported under the guidelines for Strengthening the Reporting of Observational Studies in Epidemiology. Results: The results showed that frontline nurses engaged in such tasks reported high levels of anxiety and task load and low levels of work engagement. Path analysis identified anxiety symptoms, perceived workload, perceived organizational support, and affective commitment as associated with work engagement, and among these factors, perceived organizational support and affective commitment played key roles in mediating the relationship of anxiety, workload and work engagement in high-stress working conditions. Conclusions: Affective commitment and perceived organizational support were associated with frontline nurses’ level of work engagement during the COVID-19 pandemic; these two variables might explain how engagement is generated in high-anxiety and high-workload situations. When healthcare organizations give more attention to frontline nurses’ physical and psychological conditions and are able to innovatively motivate affective commitment and facilitate organizational support, nurses’ work engagement in high-level tasks may increase, thus enhancing work safety and personal well-being.

Background: Effective preoperative digital health education (DHE) is critical for patients undergoing knee arthroplasty (KA), particularly older adults who face age-related cognitive vulnerabilities. Cognitive Load Theory suggests that presentation modality and learning motivation strongly influence cognitive processing, yet their combined effects in clinical education remain underexplored. Objective: This study investigated how learning motivation and presentation modality (text-only, text-graphic composite, and video-based) affect cognitive load and learning performance in older adult patients preparing for KA. Methods: A 2×3 factorial psychobehavioral experiment was conducted with 62 patients (≥60 y) stratified by learning motivation (high vs low). Each participant completed 6 DHE modules delivered across the 3 modalities. Cognitive load was measured using subjective ratings (Chinese National Aeronautics and Space Administration Task Load Index) and objective eye-tracking indicators (average fixation duration, number of fixations, and time to first fixation). Learning performance was assessed through knowledge retention and transfer tests (30 items). Data were analyzed using general linear models, analysis of covariance, and correlation analyses, with covariates including knee function, prior knowledge, eHealth literacy, and psychological distress. Results: High-motivation learners demonstrated significantly lower cognitive load (National Aeronautics and Space Administration Task Load Index; large effect size) and superior learning performance (medium effect size) compared to low-motivation learners. Video-based materials consistently yielded the lowest extraneous load and supported efficient knowledge acquisition (medium effect size). Text-graphic composites elicited higher cognitive load but facilitated deeper processing and schema construction, particularly for highly motivated learners (medium-to-large effect sizes). Eye tracking confirmed these dynamics: high-motivation participants showed shorter fixation durations and more efficient allocation of attention across modalities, whereas low-motivation learners displayed scattered fixation patterns, especially in text-graphic conditions. Across the sample, cognitive load was negatively correlated with learning performance (large effect size), reinforcing its role as a key mediator of digital learning outcomes. Conclusions: Both learning motivation and modality exert significant, though partly independent, influences on preoperative DHE outcomes in patients with KA. Video-based content enhances cognitive efficiency, while text-graphic formats may promote germane load among motivated learners. These findings highlight the importance of motivational scaffolding, adaptive modality selection, and the integration of real-time cognitive monitoring in DHE design. Beyond informing digital education for KA, the study demonstrates the feasibility of applying psychobehavioral experimental methods with older surgical patients, offering a framework for optimizing cognitive alignment in clinical education.

Background: Psychiatric nursing education was significantly impacted during the COVID-19 pandemic, and innovative teaching can be challenging. This study aims to compare the effectiveness of four approaches to psychiatric nursing education in the context of the pandemic.Methods: A quasi-experimental design was adopted. Students were subjected to different teaching designs: face-to-face teaching (Class A in 2021), blended teaching with flipped classroom using roleplay (Class B in 2021), live broadcast teaching (Class A in 2022), and online blended teaching with flipped classroom using case studies (Class B in 2022). Multivariable logistic regression was used to analyse the outcomes in terms of academic performance and course workload.Results: The number of valid data points was 270. The results indicated that compared with Class A in 2021, the two classes in 2022 achieved significantly higher academic performance scores, and Class B in 2021 exhibited a significantly lower workload. Compared with Class A in 2022, Class B in 2021 exhibited a significantly lower workload. Compared with Class B in 2022, Class B in 2021 exhibited a significantly lower workload and achieved lower academic performance scores.Conclusion: This study demonstrated that innovative teaching designs for psychiatric nursing offer advantages with regard to either facilitating academic performance or optimizing learners’ task loads. Furthermore, blended learning is a promising teaching approach in the context of the COVID-19 pandemic. Future teaching initiatives could adopt student-centred constructive learning designs and ensure feasible teaching.